双边带体瘤管理:技巧,技巧,策略和问题
Cesare Piazza1,2, Claudia Montenegro1,2, Vittorio Rampinelli1,2
1Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili of Brescia.
Current opinion in otolaryngology & head and neck surgery
|February 4, 2025
概括
双侧带体瘤 (BCBTs) 是罕见的,手术是首选的,但有风险. 管理较大的瘤首先降低了疾病负担,但增加了直接的风险,而较小的瘤最初风险较小,但后来治疗复杂化.
科学领域:
- 神经内分泌瘤研究研究
- 手术瘤学手术瘤学
背景情况:
- 状体瘤 (CBT) 是一种罕见的神经内分泌瘤.
- 双边CBT (BCBT) 占CBT的3-5%,与家族性综合征和恶性瘤有关.
- 缺乏对BCBTs的标准化管理,受瘤特征和患者因素的影响.
研究的目的:
- 审查当前对双边动体瘤 (BCBTs) 的管理策略.
- 评估治疗选择,包括监测,辐射和手术.
- 讨论与BCBTs手术干预相关的复杂性和风险.
主要方法:
- 审查关于BCBT管理的现有文献.
- 对治疗方式的分析:积极监测,辐射和手术.
- 讨论手术序列 (较大的与较小的瘤首先).
主要成果:
- 在可行的情况下,手术是BCBTs的主要治疗方法.
- 由于高风险,通常不建议同时切除双边瘤.
- 首先对较大的瘤进行手术会减少瘤负担,但会增加神经血管损伤的风险;首先对较小的瘤进行手术会降低初始风险,但会使后期管理复杂化.
结论:
- 手术切除是BCBTs最适合的治疗方法,尽管存在很大的神经血管并发症风险.
- 首先切除较大的瘤通常是为了减少疾病负担和进展风险而首选的,尽管它具有更高的直接危险.
- 多学科评估对于平衡手术风险,长期结果和优先考虑神经血管保护至关重要.
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